Family Medicine Obstetrics Fellowship

The mission of the Family Medicine Obstetrics (FMOB) Fellowship of Rhode Island is to train family medicine physicians in comprehensive care in the continuum of obstetric and neonatal patients in a culturally diverse community hospital setting that values collaborative, multidisciplinary care.

Through our partnerships with Landmark Medical Center in Woonsocket, RI, and with support from the Warren Alpert Medical School of Brown University, our fellows will learn to care for patients in outpatient and inpatient settings, and graduate with clinical proficiency in medically and socially complex pregnancies; management of delivery complications; and care of the newborn and the dyad. Our fellows gain competency in routine obstetric ultrasound and gain surgical obstetrics skills, including Cesarean sections.

The primary goal of our fellowship is to contribute to improved outcomes by preparing family medicine physicians to provide high-quality obstetric care to medically underserved patients and in low-resource settings.

We support a class of three FMOB fellows each academic year. Fellows participate in a one- or two-year fellowship based in a primary care clinic setting, with their experience emphasizing obstetric, reproductive health, and neonatal care. They will gain expertise in the management of both low-risk and high-risk pregnancies. All fellows will receive surgical obstetric training; those completing two years will be prepared for practice as an independent surgeon, and those completing one-year will be competent surgical assistants. Learners will also graduate with leadership, teaching, and scholarship skills, which prepares them for careers as faculty or in clinical leadership roles.

Our fellowship is based on a longitudinal weekly curriculum rather than distinct rotations, which mimics the usual schedule of a family medicine obstetrics attending.

Each fellow is based at a primary care clinic site. Two fellows are based at Thundermist Health Center (a large federally qualified health center), and the third fellow is based at Full Circle Health (a hospital-owned practice). Inpatient care is delivered at a 214-bed community hospital with a Level I nursery. Both clinic sites and the community hospital are based in Woonsocket, RI, a culturally diverse community with an industrial history, and sites are located within five minutes of each other. Our academic referral center is Women & Infants Hospital in Providence, RI, which is a primary academic training site and offers maternal-fetal medicine services and an 80-bed Level IV Neonatal Intensive Care Unit.

A typical week includes the following clinical and educational activities:

• 16 hours of primary care patient-facing time
• 4 hours of clinical administrative time
• One 24-hour inpatient shift for comprehensive inpatient obstetric and neonatal care
• 3 hours of didactics, academic, and scholarly time
• 4 hours of rotating selective time, including case review, maternal-fetal medicine ultrasound, and obstetric OMM clinic
• Additional hours of hospital call and surgical C-section call. There are scheduled overnight and weekend shifts which vary each week, but fellows will also be scheduled for weekends off each month.

Each fellow is given a family medicine panel and prenatal panel of patients to manage, with an emphasis on obstetrics, reproductive health, and newborn care. Outpatient gynecologic procedures are common in the clinic, including LARC and EMB. Additional exposure to colposcopy may be available.

The inpatient obstetrics experience includes labor management, vaginal and cesarean deliveries, external cephalic version, salpingectomy and tubal ligation, postpartum care, obstetric triage, antenatal testing including ultrasound, and newborn rounding. Circumcision procedures are optional. The floor is a Labor, Delivery, Recovery, and Postpartum Unit (LDRP), which means that fellows are caring for all peripartum and newborn patients on a single service, and learning valuable triage and floor management skills. Landmark Hospital LDRP prides itself on a collaborative environment with nursing staff and lactation consultants, and these disciplines also participate in fellow education.

All fellows are precepted to competency on limited obstetric ultrasound (including AFI) and biophysical profiles. Fellows also rotate through a local maternal fetal medicine office for extra experience and exposure to Level 2 anatomy ultrasound and genetic counseling.

On rotating Friday mornings, fellows will have the opportunity to spend time in an OMM focused clinic at Full Circle Health to learn osteopathic skills for treating common ailments of pregnancy and newborns, including but not limited to: low back pain, headaches, piriformis syndrome, torticollis, constipation, and breastfeeding pain and latch issues. This opportunity is open to both MDs and DOs, with the goal that fellows will learn hands-on skills they can use in their own continuity clinics.

The academic component of the fellowship includes structured weekly didactics, with fellows required to present during the year. This time includes training simulations, journal club reviews, case reviews, and lectures. We often feature expert guest speakers, including genetic counselors and perinatal psychiatrists. Fellows are also required to complete a research or quality improvement project and encouraged to present at a regional or national conference. Fellows may help to supervise medical and PA students who rotate on electives to grow their faculty development skills.

Some fellows design tailored elective experiences that support training to specific career goals. These are created and supported on an individual basis in consultation with the fellowship directors.

In line with our multidisciplinary approach, fellows will be supervised by a number of different providers. Core faculty are FMOB fellowship trained attendings, and each site has a faculty mentor for the fellow(s). Adjunct faculty include family medicine physicians, obstetric-gynecologists, and certified nurse midwives. Fellows will also participate in elective experiences with maternal-fetal medicine specialists.

• Graduate of an accredited family medicine residency program in the United States (at the start of fellowship)
• Family Medicine Board certified or Board eligible
• Able to work within the United States. At this time, our program is not able to sponsor visas.
• Able to hold a Rhode Island state medical license
• Excellent academic and clinical record
• Commitment to the care of underserved populations

For more information, please email the Program Directors: Susanna Magee, MD, MPH, FAAFP, and Jessica Johnson, MD, MPH, FAAFP.

• Applications are accepted on a rolling basis, with interviews starting on August 1 each year, and are open to residents in their final year or residency graduates.
• The academic year typically begins in late July (one year following application).

To apply, please email (a) your curriculum vitae (CV), (b) personal statement, (c) three letters of recommendation, and (d) current procedure logs to fmob.fellowship.of.ri@gmail.com.